A 10 year boy was brought to us in Aug 2003 with c/o mild exertional dyspnoea since childhood. There was an h/o recurrent respiratory tract infections in childhood, with failure to thrive and a small delay in developmental milestones. No h/o cyanosis. On examination, he had RV type of apex, left parasternal heave, wide, fixed splitting of S2, ESM in pulmonary area, and a Mid-diastolic murmur in tricuspid area. He was clinically diagnosed to have ASD. 2D Echo revealed a large ostium secondum type of ASD with LàR shunt, with e/o Right sided volume overload and mild pulmonary hypertension. The defect size was 18-20 mm and there was a good rim of tissue all around the defect.
In addition, there was mild thickening of mitral valve near the tips (? myxomatous,? rheumatic) but no significant diastolic gradient. The patient was subjected to ASD device closure using Amplatz device. The patient was fine for following two years with remarkable improvement in symptoms. Subsequently, he was lost to follow-up.
|Following are the links for the images of ASD with MS and Stroke :|
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